Volume 5, No. 9 - September 2016

In The Know

- Keeping you informed is what it's all about

Division Contact Information - How to Get Help

The Division offers several email addresses that allow our licensees to direct their questions to the appropriate sections and provide the fastest response from us. We have noticed many licensees write to the email address that reflects their license type regardless of the nature of their inquiry or request for assistance, which requires rerouting to the appropriate section, creating a delay in our response.

Our email addresses are published on the "Contact Us" page of every newsletter:

AgentLicensing@MyFloridaCFO.com - this is the email address for our Bureau of Licensing. This is the section of the Division that handles all licensing and education matters, and responds to questions about licensing, appointments, qualifications, requirements, pre-licensing education and testing, continuing education, etc. This section also processes license-specific requirements such as temporary bail bond agent hours certifications, submission of bonds required under certain license types, and all "deficiencies" related to an application for an agent, adjuster or agency, or other license.

There are several email address that are designated for compliance questions or issues, such as reference to laws, questions about possible violations, etc. The addresses can also be used by licensees to report suspected non-compliant activities pertaining to another licensee:

Title@MyFloridaCFO.com - for title insurance agents and agencies

BailBond@MyFloridaCFO.com - for bail bond agent and agencies

Adjusters@MyFloridaCFO.com - for all types of insurance adjusters and adjusting firms

askDFS@MyFloridaCFO.com - for general compliance questions unrelated to licensing or education

Using these valuable email addresses properly will allow the Division to respond to your inquiry as quickly and comprehensively as possible because the emails are directed to team members with the appropriate knowledge and experience in the specific subject matter.

From the Centers for Medicare & Medicaid Services (CMS) ~

Open Enrollment is right around the corner

Did you know there are less than two months left before the start of plan year 2017 Open Enrollment?

Plan ahead and complete plan year 2017 Federally-facilitated Marketplace (FFM) registration requirements now! Plan year 2017 FFM agent and broker registration and training is now available on the CMS Enterprise Portal.

Training is offered by CMS on the Marketplace Learning Management System (MLMS), and through two CMS-approved vendors: America’s Health Insurance Plans, Inc. (AHIP) and the National Association of Health Underwriters (NAHU).

CMS-approved vendors are required to cover, at a minimum, the same topic areas as are covered in the CMS training, and may offer continuing education unit (CEU) credits, depending on the state where you are licensed. Vendors may charge a fee for taking their training. Training on the MLMS platform is offered again this year at no charge.

Plan year 2017 FFM registration and training VIDEOS now available

Need assistance completing plan year 2017 FFM registration and training? Help has arrived! CMS has released two videos on the Agents and Brokers Resources webpage that include step-by-step demonstrations of completing plan year 2017 FFM registration and training:

CMS Webinar Slides posted: Are you ready to assist consumers with complex situations to enroll in Marketplace coverage?

Open Enrollment for plan year 2017 is just around the corner. Are you ready to assist consumers who have complex situations enroll in qualified health plans (QHPs) through the Federally-facilitated Marketplaces (FFMs)?

Check out our “Assisting Consumers with Complex Situations: Tips for Agents and Brokers Assisting Consumers in the FFMs” resource for pointers on helping consumers who:

    • Are part of multi-tax households
    • Have family members enrolling in different QHPs
    • Need to understand how to deal with advance payments of the premium tax credit and the premium tax credit
    • Find they are eligible for other coverage (Medicare/Medicaid/Children’s Health Insurance Program) when also enrolled in a QHP through the FFMs

Looking for more information about assisting consumers with complex situations? Check out these resources as well: “Common Complex Scenarios: Consumers who Receive an Offer of Employer-Sponsored Coverage” and “Common Complex Scenarios: Family Circumstances: Eligibility and Household Complications.”

Contact Us:

    • For information about the FFM agent and broker program, contact the Producer and Assister Help Desk via email at FFMProducer-AssisterHelpDesk@cms.hhs.gov or call the Agent and Broker Call Center at 1-855-267-1515 and select option “1.”
    • Direct questions about a client’s Individual Marketplace plan to the Marketplace Call Center at 1-800-318-2596.
    • Direct questions about Small Business Health Options Program (SHOP) Marketplace coverage to the SHOP Call Center at 1-800-706-7893.

Protecting Consumers – Helpful Resources

As an agent or broker, consumers may come to you for questions about their rights in the Marketplace and/or how to protect themselves against fraud. Check out the Agents and Brokers Resources webpage for the following fact sheets that provide important guidance on these topics.

  • The Health Insurance Marketplace: Know Your Rights: This resource includes guidance for consumers about how to get information on what their plan covers, coverage for emergency services, requesting coverage for a prescription drug that is not normally covered by their plan, and helpful resources for appealing an issuer’s decision not to pay a claim.
  • Protect Yourself from Fraud: This document includes tips to help consumers protect themselves against fraud while getting health coverage through the Marketplace at HealthCare.gov.

Learn how selling Marketplace plans through HealthCare.gov can help you grow your business

Finding affordable health and dental plans for consumers can be a challenge. Watch our new "Sell Marketplace Insurance, Build Your Business" video to learn how participating in the Federally-facilitated Marketplaces (FFMs) makes it easier to sell affordable coverage, can help you expand your client base, and allows for the same commissions you would receive when selling plans off the Marketplace.

Aerial Imaging Software Sharpens Citizens’ Eye on Storm Damage, Fraud

Citizens has acquired a new technology that uses aerial photography to produce high-resolution, 3-D building images, which employees will use to get more detailed assessments of policyholders’ claims after catastrophes, such as hurricanes.

Pictometry International’s Rapid Access® software uses aerial photographs, which are usually captured two to three days post landfall of a storm to provide sharp views of policyholders’ properties and improve Citizens’ ability to estimate and respond to major storm damage.

“The new software is a game-changer,” Citizens’ Chief of Claims Jay Adams said. “Not only does it capture detailed views of storm-struck areas, but it provides an overlay that shows which properties are insured by Citizens – and for how much.”

Citizens also acquired Pictometry’s CONNECTExplorer®, which provides a repository of historical and regularly updated aerial photography so Citizens can view and track building conditions over time, which will assist in investigating policyholders’ claims.

“Its use is wide-ranging, including applications as a fraud- and abuse-fighting tool,” said Mark Hartman, a Claims Manager who helped Citizens implement the technology. “For example, if a policyholder files a claim for a roof five years after filing one for the same roof, we can check to see whether the previous work ever was done.”

The software provides rotating views of buildings and is perhaps most useful for examining roofs, which are often the most costly and susceptible feature of a structure. Citizens insures many commercial customers for wind-only damage, and roofs are the major building feature most likely to be damaged by wind.

After a catastrophe, Citizens will use Rapid Access for triage, assigning adjusters to the hardest-hit areas. Citizens also has the ability to initiate contact with owners of commercial property – who may not even realize damage occurred – to respond quickly and prevent further damage, Hartman said.

“The real value is in providing better service to policyholders, especially after a hurricane,” Hartman said. “This new technology provides a great tool for us.”

The 2015 Florida Statutes Now Available Online

The most current Florida Statutes can now be viewed at Online Sunshine - Title XXXVII Insurance.